治疗慢性咳的P2X3受体对手的益处风险概况:基于剂量反应模型的网络元分析
Shota Yamamoto1, Nobuyuki Horita2, Johsuke Hara3
1Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI.
Chest
|June 10, 2024
概括
吉法皮克桑有效减少慢性咳,但导致味觉障碍. 新的P2X3抗剂提供了更好的安全性,Camilipixant显示出对耐火性咳的有效性和耐受性的有希望的平衡.
科学领域:
- 药理学 药理学是指药理学的学科.
- 呼吸系统医学 呼吸系统医学
- 临床试验 临床试验
背景情况:
- 耐火性慢性咳严重影响全球生活质量和医疗保健系统.
- 作为P2X3受体对手的Gefapixant被批准用于抗咳作用,但经常导致味觉障碍.
- 开发新的,更有选择性的P2X3受体对抗剂旨在减轻诸如味觉障碍等不良影响.
研究的目的:
- 为了比较五种可用的P2X3受体对抗剂的益处风险概况,用于慢性咳.
- 为了评估fefapixant,sivopixant,eliapixant,camlipixant和filapixant的疗效和安全性.
主要方法:
- 一项系统性审查和16项随机对照试验的网络元分析,涉及4,904名参与者.
- 主要结局的评估:24小时咳频率的减少和味觉障碍的发生率.
- 计算中位有效剂量 (ED50) 和效果大小的排名,使用累积排名曲线下的表面.
主要成果:
- 盖法皮克桑显示出最高的抗咳效果 (28.1%的咳减少),但也显示出最高的味觉障碍 (38/100患者) 和停止治疗的发病率.
- 卡姆利皮克桑呈现出平衡的特征,缓解了中度的咳 (14.7%) 和低的味觉障碍发病率 (每100名患者中有2人).
- 服用安慰剂的患者24小时咳频率降低了33.1%.
结论:
- 在安全剂量下,与其他P2X3抗剂相比,Fefapixant提供了有利的风险-益处概况.
- 卡姆利皮克桑特显示出潜力,并需要在正在进行的慢性咳管理的III期试验中进行进一步的研究.
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